‘Routine’ Chest X-rays Prove Otherwise – 6/24/2013

The chest x-ray: it’s often the first clinical competency student radiographers learn, and it remains one of the most frequently performed diagnostic imaging exams.

Students practice the exam repeatedly under the guidance of a radiographer until they’re declared clinically competent by their instructor. Not long after achieving this clinical milestone, however, students will realize that chest radiographs seem never-ending — they’ll be performing the exam many times on many different patients as part of their clinical education. Embracing this fact makes the learning process much more enjoyable not only for the students, but also for the radiographers and clinical instructors who work with them.

Armed with a positive attitude and willingness to perform any chest x-ray, students set out to conduct perfect posteroanterior and lateral exams. And then it happens. The imaging department is busy, so an enthusiastic student volunteers to complete a chest x-ray. “It’s only a routine exam. It won’t take that long,” the student might think. Think again!

What the student anticipates will be a “routine” chest x-ray could be very difficult if the patient is mentally challenged, quadriplegic and in a wheelchair. If the patient is accompanied by a pregnant caregiver, the situation becomes even more challenging because the caregiver can’t provide positioning assistance during the exam. In less routine exam situations like these, the student needs help from an experienced radiographer.

Experienced radiographers will recognize these situations as teachable moments. They can guide the student by demonstrating the best use of positioning sponges, immobilization techniques, creative imaging cassette placement and unique x-ray tube angulations. A combined effort between the radiographer, student and patient is essential to complete a quality diagnostic exam.

Just as students do, experienced radiographers often think we can do anything, but we forget that no exam is “routine.” As imaging professionals, we need to support each other so that we can provide every patient and his or her caregiver with a positive imaging experience. Each patient is unique, and some will present more imaging challenges than others. Embrace each session with a patient as a new opportunity to provide compassionate care and a quality exam.

Aimee Phillips, M.S., R.T.(R)(CV)(M)(QM), is the continuous improvement specialist at Marietta Hospital in Marietta, Ohio. She has been an ASRT member since 1998 and belongs to the Education, Quality Management and Radiography chapters.